Fistulotomy is a surgical procedure used to treat ‘fistula’. A fistula occurs when two organs or vessels form abnormal connections, which are otherwise not connected.
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Fistula may occur in the following regions:
Urinary tract and vagina: Fistula occurring in the urinary tract forms abnormal connections with other organs.
This includes vagina called vesicovaginal fistula, where there is hole between the vagina and bladder. urethrovaginal fistula where a hole is formed between the vagina urethra.
Anus: Anal fistulas are formed when perianal skin forms an abnormal connection with the surface of the anal canal.
There are 3 types of anal fistulas:
Anorectal fistula: it forms between anal canal and skin surrounding the anal opening.
Rectovaginal fistula: in this a hole develops between vagina and the rectum.
Colovaginal fistula: in this type a connection occurs between the colon and vagina.
Surgery is the best solution available for fistula; it is either carried out by open method or by minimally invasive method of laser surgery.
This is an outpatient procedure that lasts for an hour and the patient is discharged after it. Mostly local anesthesia is used if the fistula is small and general anesthesia is used if the fistula is a little big.
During the procedure the surgeon cuts open the abnormal connection between two organs by making an incision. The bleeding is contained and slowly the fistula is separated and removed.
The procedure is minor and can be addressed by the doctor instantly.
The minimally invasive laser surgery to treat the fistula is called Fistula laser closer or laser ablation of fistula tract.
This is an outpatient procedure that is completed within an hour and the patient can return home the very same day.
During the procedure a laser beam at 360 degrees is delivered onto the fistula from outside. The laser makes the tissue shrink. The laser is slowly withdrawn at the rate of one centimeter every three seconds and there by sealing the openings behind it gradually. The internal openings are then sealed by stitches.
During the procedure the laser beam cuts the fistula and separates it.
The recovery takes up to 12 weeks depending upon the type of fistula.
The doctor will advise bed rest for 24 hours after the surgery.
During the recovery process any kind of strenuous activity like heavy lifting and jarring movements should be avoided.
There might be some cramping post the surgery which will go away in a day or two.
Nausea felt by the patient immediately after the surgery is due to the anesthesia.
The patient might also feel constipated after surgery in such a case he/she can ask doctors for remedial medicines.
In case of bleeding, urination related issues, fever and pus formation in the incisional region it is better to get in touch with the doctor.
In case of a minimally invasive procedure the doctor will schedule an appointment after the procedure to monitor the recovery process and will keep a tab on the patient’s health so no complications arise.